Episode 3: The Crisis First Aid Kit

When something unexpected or terrible happens, we worry about the impact it will have on our child.  Will it make them vulnerable?  Will it change who they are? These are really scary thoughts for us.  Big life events usually do shift something about us, maybe drawing us even closer to our values or causing us to see the world or ourself differently.  These moments can be overwhelming, but they can also be an opportunity for us to realize our own strength, reconnect with those who love us and learn new skills that make us stronger, faster, smarter versions of ourselves.  There is no simple, one size fits all answer for how a child will be affected by a crisis.  The outcomes depend on what the crisis event is, who our child is, how they functioned before the event and how we help them cope. 

Basic Information About Traumatic Events

Something I want to be really clear on is that a traumatic event does not automatically equal traumatization.  What I mean by this is that one-third of individuals who experienced a trauma will be traumatized, if they sought professional help they would be diagnosed with Post Traumatic Stress Disorder.  Leaving the other two thirds, shaken, impacted, needing lots of support but not technically traumatized.  I mention this as a reminder of how amazing and resilient human beings are.  Especially little human beings.  And that it is so important to look at the individual and not to make assumptions based on the crisis event.

Another piece to keep in mind is that different traumatic events will affect children differently.  So as I am making suggestions, know that some of them will feel like a good fit for you and your child and others really don't seem to match the situation.  We are covering a fairly broad topic here.  And the last thing I want to be clear on is that a single traumatic event has a different impact than chronic trauma does.  I mention this because when I look at articles on this topic, aimed at parents and teachers, I notice the term chronic trauma is sometimes used, and if you are not aware of the difference they start to blend in the articles.  They have different outcomes and styles of treatment so that will confuse parents at a moment they really need clear information.

Chronic trauma is when children deal with threatening experiences regularly. This could be a neighborhood where they feel unsafe falling asleep at night or walking to and from school.  If children live with an abusive family member and are regularly harmed or threatened, they are experiencing chronic trauma.  This trauma has a deeper impact on the child's relationship with themselves and others and serious treatment and support will be required to help then learn to build trust and feel safe.  This is a different type of trauma than what we will be discussing today. I want to acknowledge it can be really disturbing thinking about any child experiencing fear or pain regularly.  I'd like to take a moment and just express my gratitude for all the community members, mental health professionals, law enforcement officers, child advocates and first responders who dedicate themselves every day to these children.  

So if your child does experience a singular traumatic event what can you do as a parent?

Monitoring

If you are a parent whose child has recently experienced a disaster, you'll be happy to know that one of the things you are probably already drawn to be doing- watching your child like a private investigator- is useful and our first recommendation. Your mindfulness skill of being present, helps you see what you need to see and move away from being consumed with worry and fear. 

If you already have that gut feeling that your child needs professional support, get it.  Absolutely trust your gut.  But stay present with observing changes in your child and trusting your response to these shifts.  If you are or are not alarmed, notice that and take it seriously, because you know your child better than anyone else.  You have such a head start in observing your child compared to a professional they are meeting for the first time.  You are comparing your child to your child.  Your child before the crisis event to after the crisis event.  Quirks, temperament, back stories, you have an understanding of all of this and so you have a much greater context to view your child's adjustment.  Your child's team members, their relatives, coaches, teachers, child care providers, pediatrician, siblings, special supports, anyone who sees your child regularly and has a relationship with them are your monitoring allies.  Don't be embarrassed to check in with them about changes you may be noticing.  They may be noticing something really important too.  Like you, your child's team has an understanding of your child's baseline or normal functioning before a crisis.   A professional will need to gather all of that information from you as part of their assessment.  This is not meant to deter you from seeking professional support but to encourage you to trust in your inner parental wisdom.  

So you are on the lookout for changes in behavior.  And keep in mind that children tend to exhibit more distress than adults do after a situation like this.  Your child may want to sleep in bed with you.  They may regress and start acting as if they are younger, crying easily, not using their words, acting out with poor behavior, complaining of stomach or headaches.  They may be focused on the event, using the example of a wildfire, they may have a lot of questions about fire and safety. Look for changes in their sleep, their eating habits, how they act with friends and siblings, how they manage school and other activities and if they are comforted by the things they previously enjoyed doing- their favorite activities.  These are all signals they are struggling to cope and may need more support and clear suggestions for how to do so.  A child that can usually process their feelings on the day to day may have trouble here because the event is so different for them.  They can be at a loss, which is what acting out, tantrums and regressed behavior usually suggest.

As we discuss coping mechanisms for you and your child, you'll see we can actually use these interventions to monitor our kids.  But before we move on, here are some explicit suggestions for when to move forward with seeking professional support.  

You may be so focused on the minute to minute after a crisis that it can be easy to forget, right before this even struck, we were dealing with normal life, which itself requires a lot from us.   What was your child coping with pre-event and how were they coping with it?  Did they have any mental health or behavioral issues before?  An event like this can exacerbate these issues.   If anyone in your family was seeing a therapist at the time of the crisis, absolutely continue working with them.  If someone is not currently seeing a therapist but had been, it's a good idea to check back in.   Life stressors such as bullying, a move, an illness, a divorce, the loss of a pet, these things that were going on for your child before the crisis are now compounded.   In this case, make an appointment for an assessment, your child may become more easily overwhelmed. The closer your child was to death, loss, destruction or violence during a crisis, the more likely they will need professional support.  If at any time they are discussing harming themselves, wanting to die or harming others, get them immediate professional support.

I think it's really useful to find the resources in your community now, that you would actually use.  So that may be getting on the phone with your insurance company and figuring out how to find professionals in your area through them, affordable or free resources that may be offered to your family through different community programs or getting a referral from a pediatrician you trust.  Have some names and contact information ready, like a mental health first aid kit, so that if you do decide your child needs more support all you have to do is call.  

Modeling

Whether this is a community disaster, a family crisis or a traumatic event you are witnessing your child deal with, you will probably be exhausted.  Give yourself permission to take really good care of yourself during this time.  Get back to your own health and wellness routine as soon as possible.  Watching the family return to a routine will make your children feel safe, and watching you practice self-care will show them how to do this and that it is valued and okay for them to do as well.  Remember when I said some of our interventions were going to help us with our monitoring?  When you have your family return to a routine you get to observe whether or not your child is able to do this.  This is really good information for you or to report to a professional.

Start Journaling.  First, it is an effective tool for managing stress and dealing with intense emotions.  And especially if you have teens or even younger children who enjoy writing, it's great modeling.  Also, you can really keep track of your observations of your own functioning and the functioning of your family members so if they do need help you have really accurate information.  If journaling just isn't your thing, that's okay but find something.  It's okay to let your family see that you are experimenting with self-care, that you are willing to try new things in order to care for yourself and your family well.

Be Gentle with Yourself.  Remember when we talked about cultivating self-compassion in Episode 2?  This is a moment where we will really need the support of that kind inner voice. You are faced with really tough decisions about your family's safety and well-being, you may be under an immense amount of pressure and may be doing all of this with little sleep and little time to emotionally process any of it.  When you hear a critical voice, acknowledge it, and then put it in its place,  remember to practice using a kind inner voice as it will help you function at your best during a difficult time.

Help Them See the Light.  Viewing the world with gratitude helps us to feel hopeful and positive.  The practice of gratitude is something we see in individuals that show resiliency to trauma or crisis.  Add pieces of this wherever it feels authentic.  You could verbalize your appreciation for the concern and support from friends and family.  This reminds your child that in the midst of painful transitions they can count on others to care about them.  We will dedicate an entire episode to gratitude because this holds so many benefits but also takes practice.  

Accept All the Feelings. Accept your feelings, accept your child's feelings.  Recognize that urge to fix this for your child and then let it go.  By accepting your own feelings about the crisis you are better able to choose how you express them.  You can take more ownership of them, in a way that people practicing self-compassion are better able to do, and model for your children that it is absolutely appropriate to have feelings about what is going on around them.  Here is an example of how to express your feelings, so you can acknowledge how difficult the situation is: "I'm sad we had to leave Benji at the animal shelter because he's such an important part of our family but the shelter is the safest place for him right now."  

Watch what happens when you start expressing your feelings like this.  When we allow ourselves this freedom, not only do our children benefit from the modeling, but it decreases our reactivity, to perhaps go buy something we'll regret, eat something we'll regret or say something we'll regret.  So start noticing this process for yourself.

If you are modeling this, your child is more likely to follow suit.  Be open and curious about your child's experience.  As heartbreaking as it feels to hear that your child may be scared or sad, know that when they can share this with you, they are not alone with these feelings.  Instead of giving into the urge to try to fix or solve your child's feelings state, which you can't do anyways, VALIDATE those feelings instead, "You're worried right now."  Just a reminder that, as we can rarely actually fix another person's feelings state and when we attempt to we are actually telling them we cannot tolerate their feelings.  They may stop expressing their negative feelings, but they don't stop experiencing them.  It can take a lot of work to accept this.

Helping Your Child Cope

Listen Carefully. So listening carefully is one of the most important things you can do for your child after a crisis event.  Your child may have a lot of questions about the crisis.  Before you panic and start trying to answer all of them, listen and ask them questions, see what they know, what they don't know, and what they have misinterpreted from watching TV or overhearing adult conversations.  Asking questions first helps you to harness your energy.  Every person is different and the things your child is actually thinking about may surprise you. Even if you don't have the answers they want, your curiosity reminds them their feelings are important and they are deeply connected to you even at this time.  

Refrain from sharing adult or graphic details but answer them honestly.  It’s okay to be brief and then check in with their thoughts and feelings. Validate these feelings. They may ask the same questions again and again, it doesn’t mean you aren’t answering them “correctly” it’s a normal part of the process.  They are seeking reassurance.  Let them know they are safe and they are loved. Remind them of their strengths and the strengths of your family or community.  Sitting with their feelings is enough, but you can also explore what being worried feels like in your child's body and offer to practice some deep breathing or body stretches if they show interest.  

Limit Media and Adult Conversation.  If this is a community crisis that is being covered by the news, try to keep the TV off around your child.  The media sensationalizes things, so there is always a sense of intensity and you are trying to create as much calm for your family as you can- these things just don't work together in harmony.  With live coverage, you never know who or what could come on the screen, that you may wish your family could unsee.  Also, try to hold off on your adult discussion of a crisis, this is not always possible but if you are not in immediate danger limit little ears overhearing adult information.  

Free Play.  This is unstructured play where children lead and decide what they want to do.  They have complete creative control.  Control, something they have had none of during a crisis, so what a nourishing experience for them.  A lot of wonderful stuff happens when children get to engage in free play and we are going to dedicate a whole episode to why this is so important.  For our purposes here, this play is useful because it helps children process their feelings about stressful situations, and express them in a safe place.   It’s how they heal.  Sit down and join them or remain close by, listen for patterns such as being scared, rescued, death, loss, helping and other themes related to the crisis.     

Return to a Routine. When possible, begin returning to a routine.  Expect lots of bumps in the road- your kind inner voice should give you a leg up on the patience you'll need.  Returning to school may be tough, coordinate with school staff and let your child bring something special from home that makes them feel connected to you, perhaps a note you wrote them or a new soft scarf you picked out together.  If your child has been sleeping with you and you want them to return to their bed, start preparing them for the fact that this is a temporary situation.  If they are in their own bed, you may notice they are having difficulty falling asleep, start their bedtime routine much earlier for a while, to help them relax and get the extra attention they need right now.

Structure Some Simple Joys. If you are still in the midst of a crisis and a routine is impossible, create structure for your child within the chaos of not knowing what the next day, hour or minute will look like.  It can be disorienting for the whole family to go hour by hour not knowing what to expect.  Once you are physically safe, pick one thing each day that you can use as your child's North Star.  If you are traveling to stay with grandparents, ask them to cook a favorite meal and this can be something your child can look forward to and count on.   Pick even the smallest thing and refer to it throughout the day so your child has some structure to orient to.  You are smoothing out the edges here of an unpredictable environment.  You are also reminding them that you are here, in charge and trustworthy as always, when you say you're having spaghetti at grandma's house, you're having spaghetti at grandma's house.  That hasn't changed even if it feels like everything else has.

Help Them Be the Light.  After we have been in survival mode, our adrenaline is pumping and we can be full of energy that feels uncomfortable and that we aren't sure what to do with. If you are safe, but now having to confront the emotional fall out of what just happened- bringing attention to others can be a relief.  Practicing small acts of kindness keeps your child's heart and mind busy and empowered. This may be gathering supplies for local shelters, sending an email filled with love to a friend or family member, or meditating or praying for those still in harm's way.  

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Kirsten Kuzirian